Changing Trends in Acute Renal Failure in Third-world Countries -- Chandigarh Study

The pattern of acute renal failure in third-world countriesis changing albeit at a slower pace compared to that in developedcountries. Of the 1862 patients with acute renal failure requiringdialysis between 1965 and 1986 in a north Indian centre, 60,15 and 25 per cent were related to medical, obstetrical andsurgical conditiom respectively. Among the medical patients,diarrhoea1 diseases which caused 23 per cent of the total numberof cases of acute renal failure in the period 1965 to 1974 causedonly 10 per cent in 1981 to 1986. In the same period, acuterenal failure due to sepsis and drugs increased while that dueto copper sulphate poisoning and intravascular haemolysis showeda downward trend. Obstetrical acute renal failure declined from22 per cent in 1965 to 1974 to 9 per cent during the period1981 to 1986. This decline was chiefly due to a fall in casesof septic abortion, puerperal sepsis a d postpartum haemorrhage.Surgical acute renal failure increased from 11 per cent duringthe period 1965 to 1974 to 31 per cent in the 1980s, predominantlydue to an increase in patients with obstructive uropathy. Despitethese favourable trends, the pattern of acute renal failurein the third world continues to be different from that in thedeveloped countries.